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Emergent Phenol Injection of Bilateral Stellate Ganglion for Management of Refractory Malignant Ventricular Arrhythmias.
- Source :
-
The American journal of case reports [Am J Case Rep] 2020 Mar 19; Vol. 21, pp. e921465. Date of Electronic Publication: 2020 Mar 19. - Publication Year :
- 2020
-
Abstract
- BACKGROUND Management of incessant electrical storm is poorly defined. These 2 case studies demonstrate a simplified percutaneous approach to achieve stellate ganglion ablation (SGA) and to promptly control malignant ventricular arrhythmias. CASE REPORT This report describes 2 patients with deteriorating hemodynamics, progressive ventricular arrhythmias, and worsening heart failure, managed with emergent percutaneous fluoroscopically-guided bilateral SGA to achieve bilateral cardiac sympathetic denervation. While supine and intubated, the left and then right stellate ganglion were identified guided by anatomic landmarks. Using a 22-guage, 3.5-inch spinal needle, contrast dye was injected with appropriate outline of the stellate ganglion at the uncinate process of the C6 vertebra. Bupivacaine 0.5% was injected, followed by phenol 6%. Successful SGA was confirmed by intentional Horner's syndrome with bilateral eye lag. The procedures were completed in about 30 min without complications and there was a dramatic reduction in ventricular arrhythmias. CONCLUSIONS Emergent percutaneous bilateral SGA can be accomplished with a brief procedure resulting in management of electrical storm.
Details
- Language :
- English
- ISSN :
- 1941-5923
- Volume :
- 21
- Database :
- MEDLINE
- Journal :
- The American journal of case reports
- Publication Type :
- Report
- Accession number :
- 32188839
- Full Text :
- https://doi.org/10.12659/AJCR.921465